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CO0047641
EnvironmentalHealth
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MARIPOSA
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1600 - Food Program
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CO0047641
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Last modified
7/10/2019 4:47:52 PM
Creation date
1/10/2019 4:26:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0047641
PE
1600
FACILITY_ID
FA0003278
FACILITY_NAME
Kmart #3174
STREET_NUMBER
2180
Direction
E
STREET_NAME
MARIPOSA
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
17306030
ENTERED_DATE
10/23/2018 12:00:00 AM
SITE_LOCATION
2180 E. MARIPOSA RD
RECEIVED_DATE
10/23/2018 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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ADMIN
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EHD - Public
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' Complaint Investigation Form Report#: 5104 <br /> COMPLAINT ID: C00047641 Site Location: 2180 E. MARIPOSA RD Account ID: AR0002852 <br /> Receivedby: EE0000014 MORENO Received Date: 10/23/2018 Print Date: 10/23/201811:08:57AM <br /> Assigned To: EE0008999 HUYNH Assigned Date: 10/23/2018 <br /> Program/Element Code:1600-FOOD PROGRAM <br /> Complainant: : <br /> <br /> <br /> Nature of complaint: <br /> 10/14/2018,PURCHASED DUNKIN DONUTS ESPRESSO COFFEE,SELL BY DATE 07/14/18.SELLING EXPIRED FOOD ITEMS. <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> I-Intemet/Email S-Sheriffs Office <br /> PROPERTY INFORMATION OWNER INFORMATION <br /> Facility:FA0003278-Kmart#3174 Owner: OW0002315-Kmart Corporation <br /> Site Location 2180 E Mariposa Rd RP/DBA : <br /> Stockton,CA 95205 RP Address <br /> <br /> <br /> <br /> <br /> : <br /> District 001-VILLAPUDUA,MIGUEL Location Code 01-STOCKTON <br /> APN 17306030 <br /> Date Abated �t 1�,L�/ Inspector ID#: <br /> Send Referral to v / Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: <br /> Circle appropriate Status Code <br /> 01-Field Response-Violations Cited and Corrected 50-LEAD Assessment Performed-No Abatement Required <br /> 02 Office Response Only 52-LEAD Abatement Reqired-See Program Record File <br /> 0 Violations Cited-see Linked PROGRAM FACILITY FILE 97-Disaster Planning and Response <br /> 07-Refferred to Other Agency 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 08-Unable to Verify Alleged Complaint MN-EHD Monitoring Status <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File PD-Permit Issued-Pending Well Installation <br /> 11-Multiple Complaints-SEE ACTIVE CASE# RS-Resolved-New Well Installed <br /> 12-DA Referred Complaint-See Program Enforcement Action Form S1-Tank pumped <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S2-Hooked up to public sewer <br /> 28-Alleged FBI-No Major Violations Identified S3-Septic system repaired <br /> 29-Alleged FBI-Major Violations Identified <br /> ompamt Reviewed y: L Y� ate: p atedby: e <br /> 5104.rpt hG 1 <br />
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